Provider Demographics
NPI:1649582933
Name:ALCANTARA, DEBRA ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ELIZABETH
Last Name:ALCANTARA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DEBRA
Other - Middle Name:ELIZABETH
Other - Last Name:GREENWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17853 SW MEADOWLARK RD
Mailing Address - Street 2:
Mailing Address - City:ROSE HILL
Mailing Address - State:KS
Mailing Address - Zip Code:67133-8186
Mailing Address - Country:US
Mailing Address - Phone:316-210-7907
Mailing Address - Fax:833-939-3552
Practice Address - Street 1:10000 W 75TH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2209
Practice Address - Country:US
Practice Address - Phone:888-913-1910
Practice Address - Fax:877-913-1174
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04167225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist